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The first case report of Yersinia enterocolitica infection in Malaysia is presented. The patient was a 34-year-old Indian woman who had a four day history of fever, abdominal pain and cough and loose stools for 2 days. She was diagnosed and treated as a case, initially of bacillary dysentery, and then of urban typhus. She responded to tetracycline therapy. Bacteriological examination eventually resulted in the isolation and identification of Yersinia enterocolitica, serotype 0:3. This case indicates the presence of the infection in Malaysia although the incidence is probably very low. This appears to be the situation in 'warm' countries.
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PMID:Yersinia enterocolitica infection: first case report from Malaysia. 638 26

During early 1982, an outbreak of yersiniosis occurred in northern Mississippi. Abdominal pain suggestive of appendicitis was a common manifestation, but laparotomy revealed mesenteric adenitis. Yersinia enteritis should enter the differential diagnosis of acute appendicitis.
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PMID:Acute yersiniosis and its surgical significance. 650 63

Two outbreaks of yersiniosis caused by Yersinia enterocolitica occurred in breeding colonies of red ruffed lemurs (Varecia variegata rubra) and black and white ruffed lemurs (Varecia variegata variegata) housed in outdoor enclosures during the winter breeding season and spring birth season, respectively. Seven of 11 animals at risk in the combined outbreaks became ill, and 3 died of acute to chronic infection. Clinical signs included anorexia, lethargy, diarrhea, abdominal pain, and hyperpyrexia. Necropsy findings included ulcerative enterocolitis and multifocal necrosis and abscess formation in mesenteric lymph nodes, liver, spleen, kidneys, and lungs. Histologically, lesions were characterized by necrotizing inflammation containing masses of basophilic bacteria. Yersinia enterocolitica serotype 0:2 was isolated from lesions. Neomycin sulfate given orally and chloramphenicol given intramuscularly were effective in treatment early in the course of the disease or in mild cases. In severe cases, lemurs did not respond to antibiotic and fluid therapy. Exposure to soil contaminated with infected rodent feces, stress, and behavioral factors in the ruffed lemur species are believed to have precipitated the infection.
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PMID:Yersinia enterocolitica infection in breeding colonies of ruffed lemurs. 651 81

In June and July 1982, a large interstate outbreak of Yersinia enterocolitica infections caused by an unusual serotype occurred in Tennessee, Arkansas, and Mississippi. Eighty-six percent of cases had enteritis characterized by fever, abdominal pain, and diarrhea. In three separate case-control studies, drinking milk pasteurized by plant A was statistically associated with illness. In a survey of randomly chosen households, 8.3% of persons who recalled having drunk milk from plant A during the suspect period experienced a yersiniosislike illness. Inspection of the plant and cultures of the available raw and pasteurized milk did not reveal the source or mechanism of contamination or a breach in normal pasteurizing technique. Although outbreaks of enteric disease caused by pasteurized milk are rare in the United States, the ability of Y enterocolitica to grow in milk at refrigeration temperatures makes pasteurized milk a possible vehicle for virulent Y enterocolitica. The extent to which milk is responsible for sporadic cases of yersiniosis is unknown.
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PMID:A multistate outbreak of infections caused by Yersinia enterocolitica transmitted by pasteurized milk. 654 13

By estimation of antibody titres or possibly isolation of the micro-organism, the role of the Yersinia enterocolitica as an etiological agent in mesenterial lymphadenitis, ileal inflammation, or abdominal colics was evaluated in 94 consecutive patients (25 operated upon and 69 treated conservatively) during a 1-year period from 1975-76. Eighty four patients (24 operated upon and 60 treated conservatively) were re-examined 5 years later. Among the 25 patients operated upon, three presented acute terminal ileitis, two of them in association with acute Y. enterocolitica infection. A substantial part of the 22 patients with other peroperative findings also presented trace or positive Y. enterocolitica antibody titres. Some of these patients experienced complaints attributable to the Y. enterocolitica infection over the following years. At re-examination, previously elevated Y. enterocolitica antibody titres had generally normalized, and in the two patients who in 1975 presented acute terminal ileitis associated with acute Y. enterocolitica infection, radiological examination now demonstrated normal terminal ileum. Among 69 patients treated conservatively for abdominal colics, 36 in 1975 presented trace or positive titres. During the 5-year follow-up period, abdominal pain and joint complaints were significantly more commonly experienced by patients with trace or positive titres than by patients with negative titres (p = 0.007 and p = 0.004, respectively). The Y. enterocolitica is an important cause of abdominal disease in our region, and the infection commonly gives symptoms of long duration.
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PMID:The Yersinia enterocolitica infection in acute abdominal surgery. A clinical study with a 5-year follow-up period. 663 78

In July 1981, an outbreak of gastroenteritis occurred at a summer diet camp. Of the 455 campers and staff, 35 per cent developed an illness characterized by abdominal pain, fever, diarrhea, and/or nausea and vomiting. A total of 53 per cent experienced abdominal pain. Seven persons were hospitalized, five of whom had appendectomies. Yersinia enterocolitica serogroup 0:8 was isolated from 37 (54 per cent) of 69 persons examined, including the camp cook and three assistants. An epidemiologic investigation demonstrated that illness was associated with consumption of reconstituted powdered milk and/or chow mein . Y. enterocolitica serogroup 0:8 was subsequently isolated from milk, the milk dispenser, and leftover chow mein . Information obtained during the investigation suggested that the Yersinia had been introduced by a food handler during food-processing procedures.
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PMID:Epidemiologic investigation of a Yersinia camp outbreak linked to a food handler. 672 Oct 15

We describe 2 patients who presented with yersinia arthritis within a period of 5 months in Leicester. Both were HLA B27 positive. Arthritis followed 2 to 3 weeks after pneumonia, abdominal pain, dysuria, and evidence of hepatic involvement in the first case, and dysuria and conjunctivitis in the second. Immunological studies showed the presence of IgM, IgG, and IgA antibodies at a significant level against Yersinia enterocolitica serotype O:3 in serum and synovial fluid, and immune complexes in the serum of the first case and synovial fluid of both. Arthropathy resolved after 16 weeks in the first case and 12 weeks in the second, the latter requiring systemic corticosteroids. Family studies revealed psoriatic spondylarthritis in the brother, and bilateral sacroiliitis in the mother of the second case. Both were HLA B27 positive. These are the fourth and fifth reported cases of yersinia arthritis in Britain. We believe the condition is probably underdiagnosed and that yersiniosis should be considered as a possibility in otherwise unexplained arthritis.
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PMID:Yersinia arthritis: a clinical, immunological, and family study of 2 cases. 697 85

The Authors describe a rare case of Yersinia Enterocolitica (Y.E.) infection in a child affected by thalassemia. The onset of the disease was that of an acute enteritis with diarrhea, fever, vomiting and abdominal pain which subsequently evolved in a picture consistent with an acute appendicitis. Laparotomy was then performed and showed a marked suppurative mesenterial lymphadenitis with mild appendicular inflammation and Y.E. infection was suspected. Culture from lymphonodes confirmed the presence of Y.E. sensitive to tobramicin and CTM. The use of these chemiotherapic agents has been followed by a rapid clinical improvement. Our recent experience could suggest some practical considerations: 1) Culture of Y.E. should be routinely performed in all children affected by acute gastroenteritis and particularly in those, above 5 years of age, in which the infection can simulate acute appendicitis. 2) Special attention should be carried out in children affected by thalassemia who can easily present more serious disease often complicated by septicemia. 3) Therapy depends on the form and severity of the disease and should be always guided by in vitro sensitivity test because of the possibility of resistence of Y.E. against the most frequently used antibiotics in septicemia.
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PMID:[Yersinia enterocolitica infection in thalassemia. Report of one case (author's transl)]. 697 42

Yersinia enterocolitica has been sought in stool and blood culture specimens by the Wisconsin State Laboratory of Hygiene (SLH) since 1973. Clinical information on symptoms, duration of illness, and use of antibiotics for 41 persons with Y. enterocolitica infections from January 1, 1979, to September 30, 1980, was obtained by telephone interviews. Diarrhea and abdominal pain were the most common symptoms of the ill persons; extraintestinal symptoms were infrequently reported. Ten infected persons (24 percent) had no illness. Review of a 10 percent sample of all stool specimens cultured at the SLH from June 20, 1977, to June 20, 1979, revealed that Salmonella was the most commonly isolated enteric pathogen (15.4 percent) followed by Shigella (2.0 percent) and Y. enterocolitica (0.7 percent). Several different biotypes and serotypes of Y. enterocolitica were associated with illness. Y. enterocolitica isolates were uniformly susceptible to a wide variety of antibiotics, and most isolates were resistant to ampicillin. Epidemiologic studies showed that persons with Y. enterocolitica infections were more likely to live in rural counties than were all persons sending stool samples or those having Salmonella infections; underlying illness was identified as a risk factor for infection.
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PMID:Human Yersinia enterocolitica infections in Wisconsin. Clinical, laboratory and epidemiologic features. 708 Dec 74

The terminal ileum and proximal colon were resected in two children presenting with fever and right lower quadrant abdominal pain. The pathological findings were characteristic; elongated ulcerations with underlying lymphoid hyperplasia involved the distal ileum and smaller punctate aphthoid ulcers involved the distal ileum and colon. Transmural inflammation was seen in both cases and resulted in thickened, erythematous distal ileum mistaken at surgery for Crohn's disease. Yersinia enterocolitica was recovered from operative cultures of both the specimens. One of the two patients had a 1:1280 serological titer for Yersinia enterocolitica 1 week after surgery. The pathologic findings of Yersinia enterocolitica ileocolitis are distinctive and easily differentiated from Crohn's disease and other pathologic processes in this region. Operative diagnosis can be difficult but if the possibility of Yersinia infection is considered, the correct diagnosis can usually be made without unnecessary surgical resection.
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PMID:The pathology of Yersinia enterocolitica ileocolitis. 711 60


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